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Septic AKI in ICU patients. diagnosis, pathophysiology, and treatment type, dosing, and timing: a comprehensive review of recent and future developments

Overview of attention for article published in Annals of Intensive Care, August 2011
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162 Mendeley
Septic AKI in ICU patients. diagnosis, pathophysiology, and treatment type, dosing, and timing: a comprehensive review of recent and future developments
Published in
Annals of Intensive Care, August 2011
DOI 10.1186/2110-5820-1-32
Pubmed ID

Patrick M Honore, Rita Jacobs, Olivier Joannes-Boyau, Jouke De Regt, Willem Boer, Elisabeth De Waele, Vincent Collin, Herbert D Spapen


Evidence is accumulating showing that septic acute kidney injury (AKI) is different from non-septic AKI. Specifically, a large body of research points to apoptotic processes underlying septic AKI. Unravelling the complex and intertwined apoptotic and immuno-inflammatory pathways at the cellular level will undoubtedly create new and exciting perspectives for the future development (e.g., caspase inhibition) or refinement (specific vasopressor use) of therapeutic strategies. Shock complicating sepsis may cause more AKI but also will render treatment of this condition in an hemodynamically unstable patient more difficult. Expert opinion, along with the aggregated results of two recent large randomized trials, favors continuous renal replacement therapy (CRRT) as preferential treatment for septic AKI (hemodynamically unstable). It is suggested that this approach might decrease the need for subsequent chronic dialysis. Large-scale introduction of citrate as an anticoagulant most likely will change CRRT management in intensive care units (ICU), because it not only significantly increases filter lifespan but also better preserves filter porosity. A possible role of citrate in reducing mortality and morbidity, mainly in surgical ICU patients, remains to be proven. Also, citrate administration in the predilution mode appears to be safe and exempt of relevant side effects, yet still requires rigorous monitoring. Current consensus exists about using a CRRT dose of 25 ml/kg/h in non-septic AKI. However, because patients should not be undertreated, this implies that doses as high as 30 to 35 ml/kg/h must be prescribed to account for eventual treatment interruptions. Awaiting results from large, ongoing trials, 35 ml/kg/h should remain the standard dose in septic AKI, particularly when shock is present. To date, exact timing of CRRT is not well defined. A widely accepted composite definition of timing is needed before an appropriate study challenging this major issue can be launched.

Mendeley readers

The data shown below were compiled from readership statistics for 162 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 3 2%
France 2 1%
Switzerland 1 <1%
Italy 1 <1%
Bulgaria 1 <1%
Iceland 1 <1%
Mexico 1 <1%
Denmark 1 <1%
Russia 1 <1%
Other 1 <1%
Unknown 149 92%

Demographic breakdown

Readers by professional status Count As %
Researcher 24 15%
Other 22 14%
Student > Postgraduate 22 14%
Student > Master 18 11%
Student > Doctoral Student 15 9%
Other 46 28%
Unknown 15 9%
Readers by discipline Count As %
Medicine and Dentistry 124 77%
Nursing and Health Professions 7 4%
Agricultural and Biological Sciences 6 4%
Pharmacology, Toxicology and Pharmaceutical Science 3 2%
Engineering 2 1%
Other 6 4%
Unknown 14 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 April 2014.
All research outputs
of 21,331,631 outputs
Outputs from Annals of Intensive Care
of 967 outputs
Outputs of similar age
of 248,753 outputs
Outputs of similar age from Annals of Intensive Care
of 9 outputs
Altmetric has tracked 21,331,631 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 967 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 15.9. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 248,753 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.
We're also able to compare this research output to 9 others from the same source and published within six weeks on either side of this one. This one has scored higher than 3 of them.